Symptoms

Whistling ears - ringing in the ears

Whistling ears - ringing in the ears


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Buzzing in the ears / tinnitus

The ear noises referred to as buzzing in the ears can be caused by a variety of causes. For example, ear noise occurs as a symptom of circulatory diseases, abnormal blood pressure, eardrum injuries, inner ear defects, inflammation, Ménière's disease (inner ear disease), metabolic disorders or tumors. Subjectively perceived noises can also trigger excessive psychological stress and stress. In addition, buzzing in the ears can be caused by acute noise pollution, such as when visiting a disco or going to a concert.

Individual symptoms

Tinnitus is the generic medical term for all ear noises as well as the so-called ringing in the ears. Since the acoustic perceptions can be side effects of serious illnesses, a doctor's visit is strongly recommended if they occur regularly. The focus of the investigation should be on the determination and treatment of possible causes of the buzzing in the ears, although numerous treatment methods promise to remedy the symptoms without going into the cause of the tinnitus in more detail.

The buzzing of the ears usually occurs as a subjectively perceived recurring ear noise, which locates the affected person in one or both ears. However, buzzing in the ears can also be perceived rather diffusely in the head, without a clear assignment to the ears being possible. Relatively often, a decrease in hearing as well as dizziness and lightheadedness appear as side effects. However, the duration and intensity of the ear noises are highly variable, so that the individual exposure for tinnitus patients is extremely different. In the medical community there is a so-called compensated for tinnitus and one decompensated tinnitus distinguished.

With compensated tinnitus, the ears are perceived, but those affected can live with them without personal impairment - the acoustic perceptions are virtually ignored. The decompensated tinnitus, on the other hand, is perceived by the patient as a significant burden and there are far-reaching consequences such as depression, sleep disorders, anxiety and concentration disorders, with effects on numerous areas of life. The tendency can be ascertained: the longer the ringing in the ears and the higher the intensity of the acoustic disturbances, the greater the stress for those affected and the risk of further health problems.

Causes of subjective tinnitus

In the case of a subjective tinnitus, according to the current state of research, the ear noises arise in the auditory system - without actually having any acoustic stimuli. There are numerous causes for the subjectively perceived buzzing in the ears. The following are named here:

  • Foreign body in the ear canal,
  • Inflammation of the ear,
  • Diseases of the middle ear (e.g. ossification of the ossicles, otosclerosis),
  • viral and bacterial infections.

So-called sound trauma, triggered by massive noise effects, is often accompanied by subjectively perceived buzzing in the ears or whistling. In addition, sudden hearing loss is also a possible cause of the stressful ear noises such as diving accidents or the rather rare diseases of the inner ear, Meniere's disease, hydrops cochleae and endolymph fluctuations. In addition, autoimmune diseases of the inner ear as well as so-called arch dendiscences, which cause hypersensitivity to noise and balance disorders, can cause the subjectively perceived buzzing of the ears.

Tumors of the auditory nerves are also possible causes of the subjective buzzing of the ears and, in the case of hearing loss (hypacusis), subjective tinnitus can occur as a kind of phantom pain. Tension in the muscles of the cervical spine and the temporomandibular joint occasionally cause ear noises, whereby the lack of movement associated with working on the PC significantly increases the risk of corresponding symptoms. In addition, psychological problems and stress are considered to be significant risk factors for buzzing ears.

Objective causes of ringing in the ears and tinnitus

Numerous causes can cause ringing in the ears, although a distinction must be made between the relatively widespread subjective and the rare objective tinnitus. While the subjective ear noises are only registered by those affected, objective tinnitus noises are based on an externally perceptible or at least measurable body's own sound source. The possible causes of objective tinnitus are relatively manageable. The most common triggers are:

  • Vascular malformations,
  • Soft palate nystagmus (soft palate disease)
  • and tube dysfunction.

Ototoxic substances as the cause

The buzzing of the ears can also be caused by numerous so-called ototoxic drugs and substances (ototoxicity = "ear toxicity"), which have a destructive effect on the inner ear. Above all, the sensory cells of the auditory and balance organs as well as the associated nerve in the brain are attacked by the ototoxic substances. The ototoxic substances include some antibiotics, cytostatics, diuretics, quinine (also contained in "Bitter Lemon" and "Tonic Water"), salicylates such as the active ingredient in aspirin (acetylsalicylic acid) and proton pump inhibitors (omeprazole). Various solvents also contain ototoxic chemicals. In addition, lead, cadmium, mercury, arsenic, carbon disulfide, carbon monoxide and cyanides are considered to be harmful to the hearing.

Acute and chronic buzzing in the ears

In addition to differentiating the buzzing of the ears according to objective and subjective perception, tinnitus in Germany is divided into acute and chronic tinnitus based on experience. Acute buzzing in the ears is therefore mentioned when the ear noises occur for a maximum of three months. If the symptoms persist for a period longer than three months, there is chronic tinnitus.

While in the acute phase tinnitus relatively often goes back without further treatment, the prospects of healing after a transition to the chronic phase are considerably poorer. Without appropriate therapy, the unpleasant ringing in the ears can accompany patients for years and become a considerable psychological burden that causes further health problems. As the treatment prospects are higher the sooner therapy is started, an ear, nose and throat doctor (ENT specialist) should be consulted at the latest one to two days after the onset of the buzzing of the ears in order to obtain a first diagnosis.

Diagnostic procedures

First of all, an in-depth examination of the throat, nose, and ears should be carried out, which serves to rule out possible previous diseases such as ear infections, sinus infections or runny nose-related ventilation disorders of the ear trumpet as causes of the buzzing in the ears. The otolaryngologist then tests the patient's sense of balance and uses a tuning fork to check your hearing. When checking the hearing, it is also possible to determine which tones are perceptible to tinnitus patients. In addition, the so-called audiometric examination provides clues about the perceived volume of the ringing in the ears and the severity of the disease.

Blood tests, X-ray tests, Doppler sonographs or magnetic resonance tomographies can follow in order to rule out further diseases that cause tinnitus. A psychoanalytic assessment of the symptoms also seems useful in order to determine possible psychological reasons for the buzzing in the ears. Because tinnitus can be caused by countless factors and often a causally oriented treatment that addresses the causes of the disease and not the symptoms promises better healing prospects, the exact diagnosis of buzzing ears is of particular importance.

Treatment methods for buzzing ears

Depending on the possible causes of tinnitus, there are numerous promising treatment methods. However, only a few of these are clearly scientifically proven and there is no generally valid therapy for correcting acoustic perceptions. In addition to the individual causes, the treatment methods should also be adapted to the clinical picture (acute / chronic). For example, acoustic stimulation procedures, behavioral therapies, drug therapies, physiotherapy and even surgical interventions are used to treat tinnitus. However, the chances of success are extremely different and are directly related to the possible causes of the buzzing in the ears.

Conventional treatment for buzzing ears

The conventional medical approach to the treatment of acute tinnitus generally provides medication with glucocorticoids (e.g. cortisone), magnesium, vitamin E preparations, intravenously administered local anesthetics and active substances that promote blood circulation. This is primarily to ensure better blood circulation and oxygen supply to the ear, since it is assumed that the acute tinnitus is the result of circulatory disorders in the small inner ear vessels. With this drug treatment, treatment successes can be achieved relatively frequently in the acute phase of tinnitus, although so far no scientific studies have been available to confirm the success of tinnitus therapies, taking into account possible placebo effects. The treatment successes to be recorded could also be attributed to the placebo effect.

If the buzzing of the ears occurs as a chronic disease, the drug treatment is usually ineffective anyway. Conventional medicine used to take such drastic measures as severing the auditory nerve in severe chronic tinnitus, but due to the low success rate, such operations are no longer carried out today. Instead, doctors use hearing aids, for example, that cover up the buzzing of the ears and should no longer be perceptible to the patient. In addition, various studies are currently investigating whether transcranial magnetic stimulation in certain areas of the brain can relieve tinnitus. Magnetic impulses stimulate the areas of the brain that have changed their activity in tinnitus patients in order to correct acoustic perceptions. The use of brain pacemakers to treat severe chronic tinnitus is also in the test phase.

Tinnitus retraining therapy

In addition, methods such as tinnitus retraining therapy, behavioral therapy or relaxation exercises are used in conventional medicine to treat chronic tinnitus. With tinnitus retraining therapy, for example, patients should learn to no longer perceive ear noises as unpleasant. The processing of tinnitus in the central nervous system and conscious perception form the focus of the therapy. The actual causes of the buzzing in the ears are, however, not further investigated in the retraining method.

At the beginning of tinnitus retrainig there is advice and information in this country, whereby the patient should learn everything about the disease. In the further course, hearing therapies are used, in which those affected are regularly exposed to acoustic signals and train their brains in dealing with sound perception. In addition, there is accompanying psychotherapeutic care for tinnitus patients, which also aims to make it easier to deal with acoustic perceptions. As part of the psychotherapeutic support, patients should also learn tinnitus preventive behavior such as sport or relaxation exercises (e.g. autogenic training).

Tinnitus treatment with behavior therapy

The cognitive behavioral therapies are mainly used in patients with severe chronic tinnitus; whereby several representative studies show clear treatment success. However, even with cognitive behavioral therapy, the tinnitus itself is not remedied, but only affects the perception of the unpleasant ringing in the ears. Cognitive-behavioral therapy was originally used primarily to treat depression, but was later transferred to other diseases in which cognition is considered to be of major importance. Mental processes of information processing, recognizing, understanding, judging and perceiving are to be understood as cognition.

When treating tinnitus with cognitive behavioral therapies, the mental perception and processing of ear noises are specifically changed so that patients ideally no longer perceive them as uncomfortable or annoying and the impairments in everyday life can be minimized.

Naturopathy and holistic medicine

As alternatives to the often expensive conventional medical treatment methods, there are numerous therapeutic options in the field of naturopathic medicine and holistic medicine, which promise similar successes at considerably lower costs and side effects. Many of these methods are now also being adopted by health insurance companies. Before the actual treatment can begin, possible causes of ringing in the ears must be determined as part of the medical history. Appropriate treatment methods are then initiated, whereby in case of doubt a referral to specialists in the respective specialist area is necessary.

Psychotherapeutic treatments, which are used on the one hand to deal with existing psychological problems and on the other hand to avoid and manage stress, are relatively often part of tinnitus therapy. In particular, stress-related buzzing in the ears should be significantly reduced or completely avoided by relaxation methods such as yoga, tai chi or autogenic training.

Massages, drainage procedures and plants

If muscle tension or back pain in the area of ​​the cervical spine is the cause of tinnitus, in naturopathy massages, physiotherapy and acupuncture are also used for treatment, but with very different success. If inner ear diseases are suspected as the cause of the buzzing in the ears, lymphatic drainage is also used in naturopathy in order to eliminate possible lymph congestion (lymphostasis) by gently massaging the lymphatic drainage vessels of the ear and thus to avoid the unpleasant acoustic perceptions.

Humor therapy or the so-called detoxifying procedures are also used for naturopathic treatment of the buzzing in the ears. The purification and detoxification therapies are intended to purify the blood and rid the body of pollutants. In addition to classic bloodletting, leech therapy, Baunscheidt therapy (not undisputed irritation of the skin with a needle device), wraps, sweating and cupping are possible methods.

Phytotherapy (herbal medicine) is also considered to be of particular importance in naturopathic tinnitus treatment. For example, the substances contained in the ginko should alleviate the buzzing of the ears, but the accompanying administration of lemon balm, hop and valerian preparations is often part of the holistic treatment approach of naturopathy. The same applies to plants that promote metabolism, such as artichokes, nettle, dandelion or milk thistle, which are also used in herbal medicine to detoxify the body.

Last but not least, homeopathy often plays a role in holistic tinnitus therapy and its administration is directly related to the various forms of tinnitus (unilateral, bilateral / acute, subacute, chronic / tone and tone intervals) and the possible causes (stress, noise) , Diseases) adapted.

Nutritional therapies

In naturopathy, nutrition is also considered to play an important role in the development of the buzzing of the ears. Since it is assumed that over-acidification of the organism can also cause the buzzing of the ears, alternative practitioners use appropriate nutritional therapies to regulate the acid-base balance in the body. Here, a vegetarian diet is also prescribed more often as part of tinnitus therapy. Furthermore, various nutritional therapies recommend a significant reduction in the intake of acidic foods, such as animal proteins (meat, sausage, fish and eggs), milk and milk products, soy products, pasta and baked goods, desserts and carbonated drinks. Caffeine (coffee, cola), alcohol and nicotine should also be avoided if possible.

In addition, it is often recommended in natural medicine to avoid synthetic food additives such as preservatives, colorings and flavor enhancers (glutamate) in order to avoid acidification of the organism. Since stress can also upset the acid-base balance, the nutritional therapies in naturopathic treatment are often coupled with appropriate behavioral therapies and relaxation exercises. In the context of nutritional therapies, a wholesome diet rich in vitamins, minerals, antioxidants and at the same time high fluid intake is usually recommended - ideally as herbal tea or non-carbonated mineral water.

Anthroposophic medicine, Ayurveda, aromatherapy

The comprehensive treatment catalog that naturopathy uses for tinnitus therapy also includes methods from anthroposophic medicine and traditional Indian medicine, Ayurveda. The treatment methods not only focus on possible physical causes of the buzzing in the ears, but also take into account mental, emotional and spiritual factors.

Furthermore, aromatherapy for tinnitus treatment is sometimes recommended. The treating practitioners mostly use essential oils, which are believed to have a health-promoting effect, for external use in massages. However, the oils can also be used at home to inhale or apply to certain parts of the body (e.g. pulse, elbow, temples). The chances of success of aromatherapy in the treatment of the buzzing of the ears are, however, rather small in comparison to the other naturopathic treatment methods.

Biofeedback for buzzing ears

Another method that is used relatively often in naturopathy for tinnitus therapy is that Biofeedback. The patient is given feedback using imaging or sounding methods about physiological parameters that are presumably cannot be influenced at will - such as heartbeat, respiratory rate, temperature, skin resistance, muscle relaxation or brain function (neurofeedback). As part of the therapeutic support, the patients learn to regulate the decisive parameters independently by means of appropriate exercises or to counteract possible derailments.

With the help of the therapist's instructions, the influence of behavior, thoughts and feelings on the various parameters and a beneficial reaction to them are learned very quickly, according to the basic idea of ​​biofeedback. In the end, the learned reactions should integrate as an automatic physiological reaction. Alternative practitioners report that, in addition to the general health-promoting effect of regulating the physiological parameters shown, biofeedback also produces a kind of distraction effect in patients with a buzz in the ears, which can help to significantly alleviate the symptoms. Because those affected concentrate on the bodily functions shown and try to influence them in a targeted manner, which means they pay less attention to the buzzing of the ears.

Ozone therapy and orthomolecular medicine

In addition, orthomolecular medicine measures are still used to treat tinnitus, even though the treatment of the buzzing of the ears with the high-dose administration of vitamins and minerals is extremely controversial among doctors. Because the experience reports, which describe a relief of the symptoms, are contrasted by scientific studies, which prove that the excessive intake of the vitamins and minerals used can lead to considerable health impairments.

Also controversial is the tinnitus treatment with the help of ozone therapy, in which up to 200 milliliters of blood are usually drawn from the patient as part of autologous blood therapy, then enriched with an ozone-oxygen mixture and injected back into the patient. The ozone is said to kill bacteria, fungi and viruses and improve blood circulation, but there are considerable side effects that can cause serious health problems.

Bach flower therapies

Bach flower therapy is also occasionally used to treat the buzzing of the ears, although so far there is no scientific evidence of a possible therapy success. According to the principles of the British doctor Edward Bach, the therapy determines the negative states of the soul, which should be the cause of all ailments and diseases, and uses different flower essences to remedy the mental balance disorders. In the 1930s, Edward Bach compared a total of 38 disharmonious states of mind with 37 different flower essences and a tincture made of rock spring water, which are said to bring about harmonization.

Although in several scientific studies no effects of Bach flower therapy could be proven, which went beyond a possible placebo effect, little speaks against the use of the flower essences for the treatment of tinnitus, since no side effects which are potentially harmful to health are known.

Altogether, naturopathy and holistic medicine offer numerous methods for treating the buzzing of the ears, the effect of which has not yet been clearly scientifically proven. In the end, the result counts for the patients and whether this was due to a placebo effect or the treatment method used is of secondary importance. (fp)

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Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters

Swell:

  • German professional association of ear, nose and throat specialists: What is tinnitus? (Accessed on 26.09.2019), hno-aerzte-im-netz.de
  • Birgit Mazurek, Agnieszka J. Szczepek, Petra Brüggemann: Tinnitus - Clinic and Therapy; Laryngo Rhino Otology 2017; 96 (01): 47-59, thieme-connect.com
  • Carol A. Bauer, Jennifer L. Berry, Thomas J. Brozoski: The effect of tinnitus retraining therapy on chronic tinnitus: A controlled trial; in: Laryngoscope Investigative Otolaryngology, Volume2, Issue4, page 166-177, August 2017, onlinelibrary.wiley.com
  • Martin Jakobs, Andres M. Lozano: Editorial. Deep brain stimulation for tinnitus: exploring the frontier between sensory perception and awareness; in: Journal of Neurosurgery (published September 24, 2019), JNS
  • Mahmoudian-Sani, M.R .; Hashemzadeh-Chaleshtori, M .; Asadi-Samani, M .; Yang, Q.: Ginkgo biloba in the treatment of tinnitus: An updated literature review; in: The International Tinnitus Journal (published June 1, 2017), PubMed
  • Cheung S.W., et al .: Phase I trial of caudate deep brain stimulation for treatment-resistant tinnitus; in Journal of Neurosurgery (published September 24, 2019), JNS


Video: How to get rid of Tinnitus naturally (October 2022).